Ovarian cancer originates in the ovaries and is a prominent gynecological malignancy. It often poses challenges for early detection because initial symptoms can be subtle and easily mistaken for other common conditions. A computed tomography (CT) scan is an imaging test healthcare providers use to examine internal body structures.
How CT Scans Visualize Internal Structures
A CT scan uses X-rays and computer processing to create detailed cross-sectional images of the body. The process involves an X-ray source and detector rotating around the patient, capturing data from multiple angles. This collected data is then reconstructed by a computer into detailed “slices” or cross-sectional views of organs, bones, and soft tissues.
These images provide information about the size, shape, and location of internal organs, helping identify masses or other abnormalities. Different tissues absorb X-rays to varying degrees, which the CT scanner translates into varying shades of gray in the images. This provides a more detailed view of internal structures compared to conventional X-rays.
CT Scans and Ovarian Cancer Detection
While CT scans can identify masses or abnormalities in the pelvic region, they are not a primary screening tool for early-stage ovarian cancer. CT scans may struggle to detect very small tumors, especially those less than 1 cm in diameter. This limitation can lead to false negative results, particularly for early-stage ovarian cancer that is confined to the ovary.
CT scans cannot definitively differentiate between benign (non-cancerous) and malignant (cancerous) masses. They can indicate the presence of larger masses, enlarged lymph nodes, or fluid accumulation in the abdomen, known as ascites, which are often associated with more advanced ovarian cancer. Such findings typically prompt further diagnostic investigations.
Other Diagnostic Methods for Ovarian Cancer
Other diagnostic tools are commonly used to evaluate suspected ovarian cancer, given CT scan limitations for initial detection. A pelvic exam is often a first step, where a healthcare provider manually feels the ovaries and uterus for abnormalities. While larger tumors might be detected, most early ovarian tumors are difficult to feel during this examination.
Transvaginal ultrasound (TVUS) is another imaging technique using sound waves to create detailed images of the uterus, fallopian tubes, and ovaries. A small probe is inserted into the vagina for a closer look at these structures. TVUS is effective for visualizing ovarian cysts and masses, but it cannot definitively determine if a mass is cancerous or benign; further evaluation is needed.
The CA-125 blood test measures levels of a protein elevated in some women with ovarian cancer. However, CA-125 levels can also be high due to non-cancerous conditions like endometriosis, uterine fibroids, or menstruation, making it an unreliable standalone screening tool. A biopsy, which involves removing a tissue sample from a suspicious area for microscopic examination, remains the definitive method for diagnosing ovarian cancer. This procedure is often performed during surgery, or through image-guided needle biopsy or laparoscopy.
CT Scans in Ovarian Cancer Management
Despite their limitations for initial detection, CT scans play a significant role in ovarian cancer management once a diagnosis is established. They are crucial for staging the cancer, determining its spread within the body. CT scans can reveal if cancer has spread to lymph nodes, other organs like the liver or spleen, or within the abdominal cavity.
This information assists healthcare teams in planning appropriate treatment, including surgical interventions or chemotherapy regimens. CT scans also monitor treatment response, assessing whether tumors are shrinking or growing. Regular CT scans help detect if cancer has recurred after treatment, providing valuable information for subsequent management decisions.